Improving outcomes in veterans with oropharyngeal squamous cell carcinoma through implementation of a multidisciplinary clinic

• Published in: Head & neck 2017-06, Vol.39 (6), p.1106-1112
• Main Authors: Light, Tyler, Rassi, Edward El, Maggiore, Ronald J., Holland, John, Reed, Julie, Suriano, Kathleen, Stooksbury, Marcelle, Tobin, Nora, Gross, Neil, Clayburgh, Daniel
• Format: Article
• Language: English
• Subjects: Age; Aged; Ambulatory Care - organization & administration; Ambulatory Care Facilities - organization & administration; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Chemoradiotherapy; Chemoradiotherapy - methods; Cohort Studies; Confidence Intervals; Dentistry; Disease-Free Survival; Female; Head & neck cancer; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; Humans; Interdisciplinary Communication; Male; Middle Aged; multidisciplinary care; Multivariate analysis; Odds Ratio; Oropharyngeal Neoplasms - mortality; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - therapy; oropharyngeal squamous cell carcinoma; Outcome Assessment (Health Care); Patient Care Team - organization & administration; Prognosis; Quality Improvement; Retrospective Studies; Risk Assessment; Speech; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck; Survival; Survival Analysis; Throat cancer; Tobacco; Treatment Outcome; treatment outcomes; United States; Veterans
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.24721

Background Treatment of head and neck cancer is complex, and a multidisciplinary clinic may improve the coordination of care. The value of a head and neck multidisciplinary clinic has not yet been established in oropharyngeal squamous cell carcinoma (SCC). Methods A retrospective review was conducted of Veterans Affairs patients with oropharyngeal SCC undergoing concurrent chemoradiation before and after implementation of the head and neck multidisciplinary clinic. Results Fifty‐two patients before and 54 patients after multidisciplinary clinic were included in this study. Age, tobacco use, and p16+ status were similar between groups. With multidisciplinary clinic, time to treatment decreased, and utilization of supportive services, including speech pathology, dentistry, and nutrition increased. The 5‐year disease‐specific survival rate increased from 63% to 81% (p = .043) after implementation of the multidisciplinary clinic. Multivariate analysis showed that disease stage (p = .016), p16 status (p = .006), and multidisciplinary clinic participation (p = .042) were predictors of disease‐specific survival. Conclusion Implementation of a multidisciplinary clinic improved care coordination and disease‐specific survival in patients with oropharyngeal SCC. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1106–1112, 2017